Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance
Background Data: Restoration of sagittal balance typically involves Smith Peterson osteotomy (SPO) or pedicle subtraction osteotomy (PSO). Since 2008, PSO was used for patients with kyphosis at our centers. Purpose: The aim of this study is to report the results of PSO for correcting fixed sagittal...
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| Format: | Article |
| Language: | English |
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Egyptian Spine Association
2012-04-01
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| Series: | Egyptian Spine Journal |
| Subjects: | |
| Online Access: | http://esj.journals.ekb.eg/article_3782.html |
| _version_ | 1818905175684808704 |
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| author | Mohammad El-Sharkawi Essam El-Sherif Wael Koptan Yasser ElMiligui |
| author_facet | Mohammad El-Sharkawi Essam El-Sherif Wael Koptan Yasser ElMiligui |
| author_sort | Mohammad El-Sharkawi |
| collection | DOAJ |
| description | Background Data: Restoration of sagittal balance typically involves Smith Peterson osteotomy (SPO) or pedicle subtraction osteotomy (PSO). Since 2008, PSO was used for patients with kyphosis at our centers. Purpose: The aim of this study is to report the results of PSO for correcting fixed sagittal imbalance at a minimum follow up of 24 months. Study Design: Prospective descriptive study. Methods: Twenty four consecutive patients with sagittal imbalance (9 females/15 males), with a mean age at surgery of 33.4 years, were treated with 25 PSOs and prospectively followed for a mean of 36 months. The etiology for imbalance was posttraumatic (n=9), Scheuermann disease (n=6), congenital (n=5), Post-tuberculous (n=3), and post-laminectomy (n=1). PSO was performed at T7 (n=1), T8 (n=1), T9 (n=2), T10
(n=1), T11 (n=3), T12 (n=4), and at L1 (n=6), L2 (n=5), and at L3 (n=2). Radiographic and clinical outcomes analysis was performed. Results: The mean operative time was 5.6±3.2 hours and the mean blood loss was 1,319±1,416 ml. Patients reported very good satisfaction (86%) and good function (79%) at final follow-up. The mean correction of the kyphotic angle at the osteotomy site was 32.3°±5.0°. No permanent neurological deficits were encountered. Postoperative
complications included pulling out of screws (n=1) and recurrence of deformity within 48 hours after surgery requiring revision and longer fixation, transient lower limb paraesthesia (n=2), superficial infection (n=1), and significant wound hematoma requiring drainage (n=2). Progressive distal junctional kyphosis occurring in a patient with Scheuermann’s disease was managed 6 months later with vertebral column resection and distal fixation. One patient developed pseudarthrosis and implant failure 9 months postoperatively. He was revised by graft augmentation and rods exchange.
Conclusion: PSO can provide satisfactory clinical and radiographic outcomes with acceptable risk and morbidity. (2012ESJ016) |
| first_indexed | 2024-12-19T21:19:10Z |
| format | Article |
| id | doaj.art-fb2b41b9743448209b3b83303e3b25e7 |
| institution | Directory Open Access Journal |
| issn | 2314-8950 2314-8969 |
| language | English |
| last_indexed | 2024-12-19T21:19:10Z |
| publishDate | 2012-04-01 |
| publisher | Egyptian Spine Association |
| record_format | Article |
| series | Egyptian Spine Journal |
| spelling | doaj.art-fb2b41b9743448209b3b83303e3b25e72022-12-21T20:05:16ZengEgyptian Spine AssociationEgyptian Spine Journal2314-89502314-89692012-04-01212029DOI:10.21608/ESJ.2012.3782Pedicle Subtraction Osteotomies for Correcting Sagittal ImbalanceMohammad El-Sharkawi0 Essam El-Sherif1Wael Koptan2 Yasser ElMiligui3Orthopaedic Department, Assiut University, Assiut, EgyptOrthopaedic Department, Assiut University, Assiut, EgyptOrthopaedic Department,Cairo University, Cairo, EgyptOrthopaedic Department,Cairo University, Cairo, EgyptBackground Data: Restoration of sagittal balance typically involves Smith Peterson osteotomy (SPO) or pedicle subtraction osteotomy (PSO). Since 2008, PSO was used for patients with kyphosis at our centers. Purpose: The aim of this study is to report the results of PSO for correcting fixed sagittal imbalance at a minimum follow up of 24 months. Study Design: Prospective descriptive study. Methods: Twenty four consecutive patients with sagittal imbalance (9 females/15 males), with a mean age at surgery of 33.4 years, were treated with 25 PSOs and prospectively followed for a mean of 36 months. The etiology for imbalance was posttraumatic (n=9), Scheuermann disease (n=6), congenital (n=5), Post-tuberculous (n=3), and post-laminectomy (n=1). PSO was performed at T7 (n=1), T8 (n=1), T9 (n=2), T10 (n=1), T11 (n=3), T12 (n=4), and at L1 (n=6), L2 (n=5), and at L3 (n=2). Radiographic and clinical outcomes analysis was performed. Results: The mean operative time was 5.6±3.2 hours and the mean blood loss was 1,319±1,416 ml. Patients reported very good satisfaction (86%) and good function (79%) at final follow-up. The mean correction of the kyphotic angle at the osteotomy site was 32.3°±5.0°. No permanent neurological deficits were encountered. Postoperative complications included pulling out of screws (n=1) and recurrence of deformity within 48 hours after surgery requiring revision and longer fixation, transient lower limb paraesthesia (n=2), superficial infection (n=1), and significant wound hematoma requiring drainage (n=2). Progressive distal junctional kyphosis occurring in a patient with Scheuermann’s disease was managed 6 months later with vertebral column resection and distal fixation. One patient developed pseudarthrosis and implant failure 9 months postoperatively. He was revised by graft augmentation and rods exchange. Conclusion: PSO can provide satisfactory clinical and radiographic outcomes with acceptable risk and morbidity. (2012ESJ016)http://esj.journals.ekb.eg/article_3782.htmlSagittal ImbalancekyphosisPSOSPOPonte OsteotomyPseudarthrosis |
| spellingShingle | Mohammad El-Sharkawi Essam El-Sherif Wael Koptan Yasser ElMiligui Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance Egyptian Spine Journal Sagittal Imbalance kyphosis PSO SPO Ponte Osteotomy Pseudarthrosis |
| title | Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance |
| title_full | Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance |
| title_fullStr | Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance |
| title_full_unstemmed | Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance |
| title_short | Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance |
| title_sort | pedicle subtraction osteotomies for correcting sagittal imbalance |
| topic | Sagittal Imbalance kyphosis PSO SPO Ponte Osteotomy Pseudarthrosis |
| url | http://esj.journals.ekb.eg/article_3782.html |
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